Nerandomilast, an inhibitor of phosphodiesterase 4B, orally administered, is a new mechanism of action to treat lung fibrotic diseases. FIBRONEER-ILD, the Phase 3 RCT of Nerandomilast in patients with progressive pulmonary fibrosis, was published in NEJM last month.

Out of 1176 patients randomized, 325 had autoimmune ILDs (RA 36.3%, systemic sclerosis 23.1%, and mixed connective tissue disease 14.5%). The results of the trail in this subpopulation was presented in LB003.

Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). Despite these therapies, APO have been reported up to 40%. An important question is whether add-on immunosuppressive therapy could improve APO. Studies in animals suggest that TNF is a critical effector of placental dysfunction and foetal death, thus a logical target.